The patient has an order for heparin 100 units over one hour.

Heparin from the pharmacy comes as 10,000 units in 500 ml. The nurse should set the pump to deliver how many ml/hr?

Choice A rationale

A penetrating chest wound can lead to pneumothorax, hemothorax, or flail chest, all of which compromise the patient's ability to breathe and exchange gases effectively. The immediate and most life-threatening consequence is acute respiratory failure. Therefore, the highest priority goal is to restore adequate gas exchange to ensure proper oxygenation of the blood and removal of carbon dioxide. This goal supersedes all others.

Choice B rationale

While effective coping is important for a patient with a long-term illness or injury, it is a psychosocial goal that is not prioritized over the immediate physiological need for life support. Coping mechanisms cannot be addressed until the patient's immediate and life-threatening medical conditions, such as respiratory failure, are stabilized.

Choice C rationale

Facilitation of long-term intubation is not a primary goal of treatment; rather, it is a potential intervention to achieve the primary goal of restoring gas exchange. The ultimate goal is to wean the patient off mechanical ventilation and extubate them as soon as medically possible, not to keep them on the ventilator long-term. The intervention is a means to an end, not the end itself.

Choice D rationale

Self-management of oxygen therapy is a long-term goal that is only applicable to patients who survive the acute phase of their illness and require supplemental oxygen at home. This goal is not appropriate for a patient in acute respiratory failure in a hospital setting. The immediate priority is the stabilization of the patient and restoration of normal respiratory function, not patient education for home care

Choice A rationale

Antibiotics are ineffective against shingles because the disease is caused by a virus, not bacteria. Shingles, or herpes zoster, is a reactivation of the varicella-zoster virus. Antibiotics target and kill bacteria by disrupting their cell walls or inhibiting protein synthesis. Administering an antibiotic would not address the viral cause of the disease and would not reduce the pain or halt its progression.

Choice B rationale

Antifungal medications are not indicated for the treatment of shingles. These drugs are specifically designed to treat infections caused by fungi by targeting the fungal cell wall or membrane. Since shingles is a viral infection, antifungal drugs would have no therapeutic effect on the varicella-zoster virus and would fail to alleviate symptoms or alter the course of the disease.

Choice C rationale

Antiviral medications are the primary treatment for shingles. These drugs, such as acyclovir, valacyclovir, and famciclovir, work by inhibiting viral DNA replication. By interrupting the viral life cycle, they can reduce the severity and duration of the outbreak, lessen the associated pain, and decrease the risk of postherpetic neuralgia. These medications are most effective when initiated within 72 hours of symptom onset.

Choice D rationale

While anti-inflammatory medications may be used to manage the pain associated with shingles, they do not halt the progression of the disease. Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids can reduce inflammation and provide symptomatic pain relief. However, they do not target the varicella-zoster virus itself. The primary treatment to stop the viral replication and disease progression is an antiviral medication. *.